HomeMy WebLinkAboutsystem inspection report 2008RALPH J. PERRY,
'NC.96 Falmouth Rd. (Route 28)Hyan n ls,MA 02601
WORK ORDER #
Phone: (508) 77SffiOVEi]
Name
Address 5cq
Contact Phone
Cooking Appliance Locations: Left to R
MA LtC. # 017 D.O.T. # A-850
SYSTEM INSPECTION REPORT
Date (s. lbra(In
Modcl #
IP,^.+ I
MfetDa/rf # of Tanks v Dry-
Annual- Semi V Recharge
-
New
-
Fusible Links 360 3 450 _ 5OO _ Other_
Fuel Shut Off P Gas _ Elecuic _
l.
2.
3.
4.
5.
6.
't.
8.
9.
10.ll.
12.
13.
14.
t5
l6
t1
l8
l9
20
21
22
23
24
25
26
27
28
29
30
3l
Ralph J Pe
Are all appliances covered by nozzles
Iry, Inc. must be norificdf
Are hood and duct covered by nozzles
Check positioning of nozzles
Hood and duct penetrations sealed
Is system U.L. 300
Proper clearance flame to filtes
Nozzle seals in place.
Are there seal tites in place
Pressure gauges in proper range
Check canridge weight
Hydrotest due
6 year maintenance due
Inspect cylinder liquid and mount
Test for proper operation from terminal link
Test remote manual operation
Micro switch in place
Gas valve in place and working
Clean nozzles no. of_Aductlplenumlappliance
Replace fusible links
Check cable, nut, and S-hook movement
All piping secured
All filters in place
CartridgeA.{2 reinstalled/Safety pin removed
System reset and oprational
All yellow seals in place
Service and certification tag on system
Ponable extinguishers up to code
Class K extinguisher and placard installed
Reviewed automatic & manual operation
of system w/customer
Exhaust fan working
Customer instructed on required monthly
inspection of system
/
_/
is any chanSe/mo r rn cooking equipment
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2.0 12
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Hood needs to be cleaned
Grease accumuladon
Excessive Heavy _
Filters need to be c
Refuses inspection
Parts had to be replaced
Maderate
leaned i}(Type 6+1*
Lr t
Liquid change
NON.COMPLIANCE ISSUED
Reason ti
Ralph J. Perry. Inc. is not a hood./duct service company
Any discrepanci
Discrepancies
es should be addressed by a qualilled hood./ducr company
or deficiencies
Type
*Non-Ccmpliance systems/or systems with discrepancies may fail
to extinguish/suppre
Next inspection due
ss a fire
Recommendations
Y
On this date, the aboye system was tested and inspected in accordance with procedures of the NFPA l7 , 17A,96, Chapter l0 2001 edition and
the manufacturer's manual at time of installation. andvrt,(u
Service Technician Lic. #21 ,'sA Representative
Plcase rcad the Customer Acknowledgemcnt on reversc side
The above service technician cenifies that the system was personally inspected and found conditions to be as indicated above
A copy of this repon will be forwarded to rhe local fire department.
was op€rated according to these above.
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CUSTOMER ACKNOWLEDGMENT
The customer understands that, unless indicated otherwise on the reverse, the service per-
formed on the Customer's equipment by a Representative of Ralph J. Perry, lnc. will indicate that
the Fire Suppression system was mechanically functioning during the period of time in which
Ralph J. Perry, lnc. Representative was performing said service. The Customer acknowledges
that Ralph J. Perry, lnc. does not guarantee, imply or suggest that the Customer's Fire Suppres-
sion System will extinguish all fires regardless of origin. The Customer further acknowledges
that Ralph J. Perry, lnc. shall have no responsibility whatsoever to the Customer or to any other
person for personal injury or death or damage to or loss of property or value, resulting from any
causes beyond reasonable control, including, without limitation, if the Fire Suppression System
is outdated, has been tampered with, altered or has been improperly used, repaired or main-
tained, or if the hazard areas protected by the Fire Suppression System has been altered or
changed.
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